One piece brace liner having multiple adjustment zones

ABSTRACT

A joint protecting brace includes a cuff member. The cuff member includes a pair of upper lateral and lower lateral tightening portions positioned on opposed sides of a cuff longitudinal axis. The cuff member further includes a liner disposed between and coupled to the upper lateral tightening portions and lower lateral tightening portions and extending along the cuff longitudinal axis. The cuff member further includes a connector coupled to a latitudinal strap. The cuff member further includes a first adjuster coupled to the upper lateral tightening portions and the connector. The cuff member further includes a second adjuster coupled to the lower lateral tightening portions and the connector. The first and second adjusters are disposed in tension for adjusting a distance between the upper and lower lateral tightening portions respectively. The first and second adjusters are communicable via the connector.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation patent application of U.S.patent application Ser. No. 11,646,060, filed on Dec. 27, 2006 nowabandoned which is a continuation patent application of U.S. patentapplication Ser. No. 11/441,951, now U.S. Pat. No. 7,182,740 filed onMay 26, 2006, the entire contents of which are incorporated herein byreference.

STATEMENT RE: FEDERALLY SPONSORED RESEARCH/DEVELOPMENT

Not Applicable

BACKGROUND

1. Field of Invention

This invention relates in general to an exteriorly positional anatomicalbrace for stabilizing a pivoting joint. Specifically, the brace includesa cuff having multiple adjustment zones allowing a user to tighten orloosen the brace. The brace prevents hyperextension of joint ligamentsby communicating the movement of a first limb structure to a second limbstructure.

2. Description

The health and well-being of all joints in the human body aresusceptible to disease and injury. The human body contains many jointsthroughout the body; however one joint in particular is very susceptibleto injury, namely, the knee joint. The knee joint is located on a legand connects the femur to the tibia. Other bones surrounding the kneejoint include the patella and the fibula. The bones of the knee jointare held together by four ligaments, namely the anterior cruciateligament, posterior cruciate ligament, medial collateral ligament, andlateral collateral ligament. An injury to the knee involves a strain ortear in any of the above-mentioned ligaments.

An injury to the knee joint may occur during normal, everyday activity.A simple misstep or twist in the wrong direction could strain or tear aligament. However, injury is more likely to occur during sports relatedactivities. During such activities, large forces may be applied to thejoint, thereby causing a strain or tear in one or more of the ligaments.For example, in football, as players are tackled, a player may sustain ahit directly to his knee; in basketball, players apply forces to theirknees when they routinely change their direction by planting their footand quickly changing their course. However, one sport that canparticularly cause considerable injury to a knee is motocross. Inmotocross, a rider's knee acts as a shock absorber as the ridertraverses over a course's rough terrain by landing large jumps, ormaneuvering through a series of bumps. In addition to acting as a shockabsorber, a rider's knee is susceptible to sudden twists which can causeinjury. For instance, as a rider moves through the course, his foot mayget caught in the dirt, thereby twisting the rider's knee.

Whatever the activity may be, one can mitigate the chance of injuring ajoint by fitting a brace around the joint. Athletes have been protectingtheir knees by wearing knee braces for years. A knee brace protects theknee joint by stabilizing the bones surrounding the knee. By stabilizingthe movement of the bones, the changes of straining or tearing aligament is lessened.

In the related art, most braces include an upper frame member attachedto a first limb structure and a lower frame member attached to a secondlimb structure. Each frame member typically includes an adjustable cuffpositionable on a concave surface of the joint. The cuff can betightened to secure the frame member to its respective limb structure.

Despite the protection offered by most braces, injuries to jointscontinue to occur. A number of injuries occur because of the lack ofprotection on the concave surface of the joint. Chief among suchinjuries are hyperextensions of the knee ligaments. Hyperextensionscontinue to occur despite the presence of a knee brace because of thelack of support and stabilization on the concave surface of the joint.The typical knee brace does not stabilize the rearward movement of thefirst limb structure relative to the second limb structure. As such,there is a need in the art for an improved knee brace that preventshyperextension of the joint by preventing the rearward movement of thefirst and second limb structures relative to each other.

BRIEF SUMMARY

According to an aspect of the present invention there is provided anexteriorly positional anatomical brace for stabilizing a pivoting joint.The joint is disposed between a first limb structure and a second limbstructure of a living being. The pivoting joint includes a concavesurface.

The brace includes an upper frame member positionable adjacent the firstlimb structure and a lower frame member positionable adjacent the secondlimb structure. The brace further includes a joint member pivotallyconnecting the upper frame member and the lower frame member. The bracealso includes a cuff member. The cuff member includes a pair of upperlateral tightening portions positioned on opposed sides of a cufflongitudinal axis. The upper lateral tightening portions are attached tothe upper frame member. The cuff member further includes a pair of lowerlateral tightening portions positioned on opposed sides of the cufflongitudinal axis. The lower lateral tightening portions are attached tothe lower frame member. The cuff member further includes a linerextending along the cuff longitudinal axis. The liner is disposedbetween and coupled to the upper lateral tightening portions. The lineris also disposed between and coupled to the lower lateral tighteningportions. The liner includes a bend region positionable adjacent theconcave surface of the joint. The bend region is located between upperand lower lateral tightening portions. The cuff member further includesa latitudinal strap positioned along the bend region, and a connectorcoupled to the latitudinal strap. The connector includes a top regionand a bottom region. The cuff member further includes a first adjustercoupled to the upper lateral tightening portions and the top region ofthe connector. The first adjuster is disposed in tension for adjusting afirst distance between the upper lateral tightening portions. The cuffmember further includes a second adjuster coupled to the lower lateraltightening portions and the bottom region of the connector. The secondadjuster is disposed in tension for adjusting a first distance betweenthe lower lateral tightening portions. The first and second adjustersare communicable via the connector.

In operation, the brace is secured to the user such that the upper framemember is positioned adjacent the first limb structure, the lower framemember is positioned adjacent the second limb structure, and the lineris positioned adjacent the concave surface of the joint. The firstadjuster is disposed in tension thereby decreasing the distance betweenthe pair of upper lateral tightening portions and increasing thepressure applied by the cuff member to the first limb structure. Thesecond adjuster is additionally disposed in tension, thereby decreasingthe distance between the pair of lower lateral tightening portions andincreasing the pressure applied by the cuff member to the second limbstructure. The first and second adjusters are communicable via theconnector member. Therefore, as the tension in the first adjusterincreases, the tension in the second adjuster also increases. Likewise,as the tension in the second adjuster increases, the tension in thefirst adjuster also increases. Such communicability links the movementof the first limb structure to the movement of the second limbstructure, thereby reducing the risk of injury to the joint.

According to various embodiments of the invention, the cuff member mayinclude a third adjuster coupled to the upper lateral tighteningportions. The third adjuster may be disposed in tension for adjusting asecond distance between the upper lateral tightening portions. The cuffmember may further include a fourth adjuster coupled to the lowerlateral tightening portions. The fourth adjuster may be disposed intension for adjusting a second distance between the lower lateraltightening portions. In such embodiments including first, second, thirdand fourth adjusters, the cuff member will be considered to have fourzones of adjustment. Each adjuster is considered to control one zone ofadjustment.

The cuff member may further include a longitudinal strap coupled to theliner. The longitudinal strap may be positioned along the longitudinalaxis. The connector may be coupled to the longitudinal strap to positionthe connector adjacent the liner.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features and advantages of the various embodimentsdisclosed herein will be better understood with respect to the followingdescription and drawings, in which like numbers refer to like partsthroughout, and in which:

FIG. 1 is a perspective lateral view of an exteriorly positionalanatomical brace having a cuff member, the brace positioned on a leg ofa user shown in phantom;

FIG. 2 is a perspective front view of the brace;

FIG. 3 is a perspective medial view of the brace without adjusters;

FIG. 4 is an elevation view of a cuff member with first and secondadjusters shown coupled to upper and lower lateral tightening portions,respectively, and the first and second adjusters being communicable viaa connector member;

FIG. 5 is an elevation view of the cuff member of FIG. 4 with third andfourth adjusters shown coupled to the upper and lower lateral tighteningportions, respectively;

FIG. 6 is a perspective rear view of the brace of FIG. 1 having first,second, third and fourth adjusters; and

FIG. 7 is a perspective view of the connector.

DETAILED DESCRIPTION

An aspect of the present invention is a device designed to protect ajoint of a user. Such a joint is located between a first limb structureand a second limb structure of the user. The device is intended to besecured to the first and second limb structures. The device protects thejoint by stabilizing the movement of the first and second limbstructures.

Referring to FIGS. 1-3, an exteriorly positional anatomical brace 10 isshown in place on a user 2. In the embodiment illustrated in FIGS. 1-3,the device is shown on a knee of the user 2, where the first limbstructure 6 is an upper leg and the second limb structure 8 is a lowerleg.

The brace 10 includes an upper frame member 11 positionable adjacent thefirst limb structure 6 of the user 2 and a lower frame member 12positionable adjacent the second limb structure 8 of the user 2. Thebrace 10 further includes a joint member 14 pivotally connecting theupper frame member 11 and the lower frame member 12. The brace 10 alsoincludes a cuff member 16. The cuff member 16 includes a pair of upperlateral tightening portions 18 positioned on opposed sides of a cufflongitudinal axis 20. The upper lateral tightening portions 18 attach tothe upper frame member 11. The cuff member 16 further includes a pair oflower lateral tightening portions 22 positioned on opposed sides of thecuff longitudinal axis 20. The lower lateral tightening portions 22attach to the lower frame member 12. The cuff member 16 further includesa liner 24 extending along the cuff longitudinal axis 20. The liner 24is disposed between and coupled to the upper lateral tightening portions18. The liner 24 is also disposed between and coupled to the lowerlateral tightening portions 22. The liner 24 includes a bend region 26positionable adjacent the concave surface of the joint. The bend region26 is located between upper and lower lateral tightening portions 18,22. The cuff member 16 further includes a latitudinal strap 30positioned along the bend region 26 of the liner 24. The cuff member 16further includes a connector 32 coupled to the latitudinal strap 30. Theconnector 32 includes a top region 34 and a bottom region 36. The cuffmember 16 further includes a first adjuster 38 coupled to the upperlateral tightening portions 18 and the top region 34 of the connector32. The first adjuster 38 is disposed in tension for adjusting a firstdistance between the upper lateral tightening portions 18. The cuffmember 16 further includes a second adjuster 40 coupled to the lowerlateral tightening portions 22 and the bottom region 36 of the connector32. The second adjuster 40 is disposed in tension for adjusting a firstdistance between the lower lateral tightening portions 22. The first andsecond adjusters 38, 40 are communicable via the connector 32.

As described above, the upper and lower frame members 11, 12 arepositionable adjacent the first and second limb structures 6, 8,respectively. In this regard, the upper and lower frame members 11, 12are positioned near or close to the first and second limb structures 6,8, but not necessarily touching the limb structures 6, 8. The upperframe member 11 is pivotally connected to the lower frame member 12 viathe joint member 14. In this regard, the upper and lower frame members11, 12 connect to the joint member 14 such that the upper frame member11 and the lower frame member 12 rotate about the joint member 14.

FIGS. 1 and 3 show the cuff member 16 attached to the upper and lowerframe members 11, 12. The cuff member 16 includes upper and lowerlateral tightening portions 18, 22. The upper and lower lateraltightening portions 18, 22 attach to the upper and lower frame members11, 12, respectively. Such attachment is preferably a detachableattachment, such as a snap fastener, or a hook and loop fastener.However, the upper and lower lateral tightening portions 18, 22 may bepermanently attached to the upper and lower frame members 11, 12 usingpermanent attachment devices such as a rivet or screw.

FIGS. 4 and 5 show the cuff member 16 having a pair of upper and lowerlateral tightening portions 18, 22. The pair of upper lateral tighteningportions 18 are positioned on opposed sides of the cuff longitudinalaxis 20. In this regard, an upper lateral tightening portion 18 islocated on either side of the cuff longitudinal axis 20. The pair oflower lateral tightening portions 22 are also positioned on opposedsides of the cuff longitudinal axis 20. As such, a lower lateraltightening portion 22 is located on either side of the cuff longitudinalaxis 20. As shown in FIGS. 4 and 5, the pair of upper lateral tighteningportions 18 are not integrally formed. The pair of lower lateraltightening portions 22 are also not integrally formed. However, theupper lateral tightening portions 18 and the lower lateral tighteningportions 22 may be integrally formed without departing from the scope ofthe invention.

FIGS. 4 and 5 also show the liner 24 extending along the cufflongitudinal axis 20. Preferably, the liner 24 is comprised of anelastic material, capable of bending without losing its structuralintegrity. As mentioned above, the liner 24 is disposed between the pairof upper lateral tightening portions 18. In this regard, the liner 24extends between the pair of upper lateral tightening portions 18. Inaddition, the liner 24 is also disposed between the pair of lowerlateral tightening portions 22. As such, the liner 24 extends betweenthe pair of lower lateral tightening portions 22. The liner is coupledto the upper lateral tightening portions and the lower lateraltightening portions. Preferably, the liner 24 is sewn or stitched to theupper and lower lateral tightening portions 18, 22, thereby permanentlycoupling the liner 24 to the upper and lower lateral tightening portions18, 22.

In the preferred embodiment of the invention, the cuff member 16includes only one liner 24, as is shown in FIGS. 4 and 5. The liner 24extends along the cuff longitudinal axis 20 from the lower frame member11 to the upper frame member 12. As explained above, the liner 24includes a bend region 26 located between the upper and lower lateraltightening portions 18, 22. The bend region 26 is positionable adjacentthe concave surface of the joint. In this regard, the bend region 26 issituated next to or near the concave surface of the joint. The bendregion 26 does not necessarily have to be in contact with the concavesurface of the joint.

The cuff member 16 having a connector 32. As mentioned above, theconnector 32 is coupled to the latitudinal strap 30. In this regard, theconnector 32 is fixedly coupled to the latitudinal strap 30 by beingstitched or sewn to the strap 30. However, the connector 32 may bedetachably coupled to the strap 30 using snap fasteners or hook and loopfasteners. The latitudinal strap 30 holds the connector 32 in place,adjacent to the liner 24, as the brace 10 is in use.

FIG. 4 shows the cuff member 16 having first and second adjusters 38,40. Preferably the first and second adjusters 38, 40 are comprised of anon-elastomeric lace. As described above, the first adjuster 38 iscoupled to the upper lateral tightening portions 18 and the top region34 of the connector 32. The second adjuster 40 is coupled to the lowerlateral tightening portions 22 and the bottom region 36 of the connector32. The top region 34 of the connector 32 is the region through whichthe first adjuster 38 passes through. The bottom region 36 of theconnector 32 is the region through which the second adjuster 40 passesthrough. As shown in FIG. 4, the upper and lower lateral tighteningportions 18, 22 are provided with eyelets which the first and secondadjusters 38, 40 are laced through.

The first adjuster 38 is disposed in tension for adjusting a firstdistance between the upper lateral tightening portions 18. In thisregard, as the user 2 increases the tension in the first adjuster 38,the distance between the upper lateral tightening portions 18 decreases,thereby increasing the pressure applied by the cuff member 16 to thefirst limb structure 6. Likewise, the second adjuster 40 is disposed intension for adjusting a first distance between the lower lateraltightening portions 22. As the user 2 increases the tension in thesecond adjuster 40, the distance between the lower lateral tighteningportions 22 decreases, thereby increasing the pressure applied by thecuff member 16 to the second limb structure 8.

The tensions of the first and second adjusters 38, 40 are communicablevia the connector 32. The tensions of the first and second adjusters 38,40 fluctuate as the user 2 moves his first and second limb structures 6,8. The tension in the first or second adjusters 38, 40 increases whenone of the first or second limb structures 6, 8 begins to separate orextend from its natural position in the joint. A hyperextension of thejoint occurs when one of the first or second limb structures 6, 8separates from its natural position so as to strain or tear theligaments securing the joint. An increase in tension in one of the firstor second adjusters 38, 40, is communicated to the other one of thefirst or second adjusters 38, 40 via the connector 32. By communicatingthe increase in tension in one of the first or second adjusters 38, 40to the other one of the first or second adjusters 38, 40 the pressure ofthe entire cuff member 16, as applied to the first and second limbstructures 6, 8 increases. The increase in pressure of the cuff member16 as applied to the first and second limb structures 6, 8 stabilizesthe joint thereby decreasing the chances of hyperextending the joint.

FIG. 7 shows a perspective view of the connector 32. Preferably, theconnector 32 guides the first adjuster 38 such that when the firstadjuster 38 is disposed in tension, the portions of the first adjuster38 exiting the top region 34 of the connector 32 are directed innon-parallel directions. Likewise, the connector 32 guides the secondadjuster 40 such that when the second adjuster 40 is disposed intension, the portions of the second adjuster 40 exiting the bottomregion 36 of the connector 32 are directed in non-parallel directions.Therefore, as the tension increases in any of the directions of one ofthe first or second adjusters 38, 40, such increase in tension iscommunicated to the other one of the first or second adjusters 38, 40.

The cuff member 16 may also include a third adjuster 42 and a fourthadjuster 44. FIG. 5 shows a view of the cuff member 16 having third andfourth adjusters 42, 44. Preferably, the third and fourth adjusters 42,44 will be used in addition to the first and second adjusters 38, 40.The third adjuster 42 is coupled to the pair of upper lateral tighteningportions 18. The third adjuster 42 is disposed in tension for adjustinga second distance between the upper lateral tightening portions 18.Similarly, the fourth adjuster 44 is coupled to the pair of lowerlateral tightening portions 22. The fourth adjuster 44 is disposed intension for adjusting a second distance between the lower lateraltightening portions 22.

According to an aspect of the present invention, a user 2 is able totighten or loosen the brace 10 by adjusting the tension in the adjusters38, 40, 42, 44. Each adjuster 38, 40, 42, 44 controls one zone ofadjustment. Preferably, the brace 10 includes multiple zones ofadjustment. FIG. 6 is a perspective rear view of the brace 10 havingfirst, second, third and fourth adjusters 38, 40, 42, 44. In such anembodiment, the brace 10 has four zones of adjustment; two control theupper lateral tightening portions 18, while two control the lowerlateral tightening portions 22.

The adjusters 38, 40, 42, 44 must be capable of being disposed intension. The preferred material for the adjusters 38, 40, 42, 44 is anon-elastomeric lace, or other appropriate materials as would berecognized by the skilled artisan.

FIGS. 4-5 shows an alternative embodiment of the brace 10 containing alongitudinal strap 46. The longitudinal strap 46 is coupled to the liner24 and positioned along the cuff longitudinal axis 20. The longitudinalstrap 46 connects the liner 24 to the connector 32. Therefore, as theliner 24 expands or stretches the connector 32 moves accordingly.

In operation, a user 2 secures the brace 10 to the first and second limbstructures 6, 8. As shown in FIGS. 1, 2 and 3, the user 2 secures thebrace 10 to the leg 4 of a user 2. The brace 10 is secured to the user 2by positioning the upper frame member 11 adjacent the first limbstructure 6 and positioning the lower frame member 12 adjacent thesecond limb structure 8. A cuff member 16 is attached to the upper andlower frame members 18, 22. The cuff member 16 is positioned such thatthe bend region 26 of the liner 24 is adjacent the concave surface ofthe joint of the user 2. The user 2 adjusts a first distance between thepair of upper lateral tightening portions 18 by disposing the firstadjuster 38 in tension. The user 2 also adjusts a first distance betweenthe pair of lower lateral tightening portions 22 by disposing the secondadjuster 40 in tension. A connector 32 communicates the tensile forcesof the first adjuster 38 with the tensile forces of the second adjuster40.

The brace 10 may also include third and fourth adjusters 42, 44. A user2 may adjust a second distance between the pair of upper lateraltightening portions 18 using the third adjuster 42. Similarly, a user 2may adjust a second distance between the pair of lower lateraltightening portions 22 using the fourth adjuster 44.

The increase in tension in the adjusters 38, 40, 42, 44 increases thepressure applied by the cuff member 16 to the first and second limbstructures 6, 8. As the tension in one of the first or second adjusters38, 40 increases, the connector 32 communicates the increase in tensionto the other one of the first and second adjusters 38, 40. The tensionin the other one of the first or second adjusters 38, 40 is therebyincreased. The increase in tension stabilizes the joint and preventshyperextension.

While an illustrative and presently preferred embodiment of theinvention has been described in detail herein, it is to be understoodthat the inventive concepts may be otherwise variously embodied andemployed and that the appended claims are intended to be construed toinclude such variations except insofar as limited by the prior art.

1. An exteriorly positional anatomical brace for stabilizing a pivotingjoint, the joint being disposed between a first limb structure and asecond limb structure of a living being, the joint having a concavesurface, the brace comprising: an upper frame member positionableadjacent the first limb structure; a lower frame member positionableadjacent the second limb structure; a joint member pivotally connectingthe upper frame member and the lower frame member; and a cuff memberincluding: a pair of upper lateral tightening portions positioned onopposed sides of a cuff longitudinal axis, the upper lateral tighteningportions being attached to the upper frame member; a pair of lowerlateral tightening portions positioned on opposed sides of the cufflongitudinal axis, the lower lateral tightening portions being attachedto the lower frame member; a liner extending along the cuff longitudinalaxis, the liner disposed between and coupled to the upper lateraltightening portions, the liner disposed between and coupled to the lowerlateral tightening portions, the liner having a bend region positionableadjacent the concave surface of the joint, the bend region locatedbetween upper and lower lateral tightening portions; a latitudinal strappositioned along the bend region; a connector coupled to the latitudinalstrap, the connector having a top region and a bottom region; a firstadjuster coupled to the upper lateral tightening portions and the topregion of the connector, the first adjuster being disposable in tensionto bias the pair of upper lateral tightening portions toward each otherfor securing the cuff to the first limb structure; and a second adjustercoupled the lower lateral tightening portions and the bottom region ofthe connector, the second adjuster being disposable in tension to biasthe pair of lower lateral tightening portions toward each other forsecuring the cuff to the second limb structure, the first and secondadjusters being communicable via the connector such that when the firstlimb structure separates from the second limb structure, the tension inthe first adjuster increases and the tension in the second adjusterincreases to mitigate further separation of the first limb structurefrom the second limb structure.
 2. The brace of claim 1, wherein thecuff member is further comprised of a third adjuster coupled to theupper lateral tightening portions, the third adjuster being disposed intension for adjusting a second distance between the upper lateraltightening portions.
 3. The brace of claim 1, wherein the cuff member isfurther comprised of a fourth adjuster coupled to the lower lateraltightening portions, the fourth adjuster being disposed in tension foradjusting a second distance between the lower lateral tighteningportions.
 4. The brace of claim 1, wherein the cuff member is furthercomprised of a longitudinal strap coupled to the liner, the longitudinalstrap being positioned along the longitudinal axis.
 5. The brace ofclaim 1, wherein the liner is comprised of an elastic material.
 6. Thebrace of claim 1, wherein the first adjuster is comprised ofnon-elastomeric lace.
 7. The brace of claim 1, wherein the secondadjuster is comprised of non-elastomeric lace.
 8. The brace of claim 2,wherein the third adjuster is comprised of non-elastomeric lace.
 9. Thebrace of claim 3, wherein the fourth adjuster is comprised ofnon-elastomeric lace.
 10. An exteriorly positional anatomical brace forstabilizing a pivoting joint, the joint being disposed between a firstlimb structure and a second limb structure of a living being, the jointhaving a concave surface, the brace comprising: an upper frame memberpositionable adjacent the first limb structure; a lower frame memberpositionable adjacent the second limb structure; a joint memberpivotally connecting the upper frame member and the lower frame member;and a cuff member including: a pair of upper lateral tightening portionspositioned on opposed sides of a cuff longitudinal axis, the upperlateral tightening portions being attached to the upper frame member; apair of lower lateral tightening portions positioned on opposed sides ofthe cuff longitudinal axis, the lower lateral tightening portions beingattached to the lower frame member; a connector disposed between thepair of upper lateral tightening portions and the pair of lower lateraltightening portions, the connector having a top region and a bottomregion; a first adjuster coupled to the upper lateral tighteningportions and the top region of the connector, the first adjuster beingdisposable in tension to bias the pair of upper lateral tighteningportions toward each other for securing the cuff to the first limbstructure; and a second adjuster coupled the lower lateral tighteningportions and the bottom region of the connector, the second adjusterbeing disposable in tension to bias the pair of lower lateral tighteningportions toward each other for securing the cuff to the second limbstructure, the first and second adjusters being communicable via theconnector such that when the first limb structure separates from thesecond limb structure, the tension in the first adjuster increases andthe tension in the second adjuster increases to mitigate furtherseparation of the first limb structure from the second limb structure.11. The brace of claim 10, wherein the cuff member is further comprisedof a third adjuster coupled to the upper lateral tightening portions,the third adjuster being disposed in tension for adjusting a seconddistance between the upper lateral tightening portions.
 12. The brace ofclaim 10, wherein the cuff member is further comprised of a fourthadjuster coupled to the lower lateral tightening portions, the fourthadjuster being disposed in tension for adjusting a second distancebetween the lower lateral tightening portions.
 13. The brace of claim10, wherein the first adjuster is comprised of non-elastomeric lace. 14.The brace of claim 10, wherein the second adjuster is comprised ofnon-elastomeric lace.
 15. The brace of claim 11, wherein the thirdadjuster is comprised of non-elastomeric lace.
 16. The brace of claim12, wherein the fourth adjuster is comprised of non-elastomeric lace.17. The brace of claim 1, wherein the joint member is disposablelaterally relative to the pivoting joint.
 18. The brace of claim 1,wherein the pair of upper lateral tightening portions extendlongitudinally in a direction that is generally parallel to the cufflongitudinal axis.
 19. The brace of claim 18, wherein the pair of upperlateral tightening portions are moveable toward each other in adirection orthogonal to the cuff longitudinal axis to adjust the cuff.